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CMS Medicare Secondary Payer Recovery Portal

Guidance for Medicare Secondary Payer Recovery Portal (MSPRP) tool, a web-based tool designed to assist in the resolution of liability insurance, no-fault insurance, and workers' compensation Medicare recovery cases.

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: June 30, 2020

The Medicare Secondary Payer Recovery Portal (MSPRP) is a web-based tool designed to assist in the resolution of liability insurance, no-fault insurance, and workers' compensation Medicare recovery cases. The MSPRP gives you the ability to access and update certain case specific information online.

CMS has made available a curriculum of computer-based training (CBT) courses for the MSPRP. These courses provide in-depth training on use of the MSPRP. You can access or download these CBTs from the Dynamic List on this page. Please see the MSPRP Curriculum for a complete listing of the courses and their descriptions. If you have any questions or feedback on this material, please click the Training Feedback link.

MSPRP Features & Benefits:

The MSPRP provides you with the following features and related benefits:

1. Submit Beneficiary Proof of Representation, Beneficiary Consent to Release or Insurer Letter of Authority documentation

2. Request conditional payment information:

  • Obtain the current conditional payment amount
  • Request a printed or electronic copy of the current conditional payment letter
  • Request a final conditional payment amount for a case that is approaching settlement

3. Dispute claims included in the conditional payment amount:

  • View claim details for the claims associated to the case
  • Dispute unrelated claims and upload documentation to support the claim dispute

4. Initiate the demand letter:

  • If you agree with the Conditional Payment Notice amount, you may initiate a demand letter earlier than the default 30-day time period.

5. View the status of correspondence that has been sent and received for a case

6. Submit case settlement information:

  • Input settlement information and upload a copy of the settlement documentation

7. Submit waiver, compromise and redetermination requests:

  • View details of the request: received date, decision and decision date

8. Multi-Factor Authorization (MFA) and Identity Proofing:

  • Request access to view unmasked claims data. Individuals requesting this access must complete the ID Proofing and MFA process.

Note: Only those actions that are applicable to the case will be available.

9. Self-Report A Case

10. Make an Electronic Payment (ePay):

  • Make payments via Pay.gov using ACH (banking account information), debit card, and PayPal.  For instructions on how to initiate an electronic payment, access the computer based training module, "Electronic Payment" - Course ID 21, located in the Dynamic List on this page.

How to Access the MSPRP

Beneficiaries do not need to register for an account on the MSPRP.  Beneficiaries can access the MSPRP through the Medicare.Gov Web site using their established Login ID and Password for that site. The Web site can be accessed from the link: www.Medicare.gov

Insurers and attorneys will access the MSPRP using the following MSPRP Application link: https://www.cob.cms.hhs.gov/MSPRP/. Please note that registration must occur before access to the MSPRP is permitted. Additionally, you must complete the Identity Proofing and Multi-Factor Authentication process on the MSPRP if you wish to request access to unmasked claims data. See the MSPRP User Guide and the Remote Identity Proofing (RIDP) - Multifactor Authentication (MFA) on the Medicare Secondary Payer Recovery Portal (MSPRP) Frequently Asked Questions. The FAQ is available under the ‘Reference Material’ menu option of the MSPRP application.

MSPRP User Guide

The MSPRP User Guide was written to help you understand how to use the MSPRP. The User Guide is available under the ‘Reference Material’ menu option of the MSPRP application.

Assistance with MSPRP Issues

For problems related to registration and other technical issues, please contact the Benefits Coordination & Recovery Center (BCRC) EDI Department at 1-646-458-6740.

For questions related to a case or why an MSPRP option is unavailable (i.e., grayed out), please contact the BCRC at 1-855-798-2627.

HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.